Blank Admission Form

1

Program Details

Applied Class

Faculty / Stream

Optional Subject I

Optional Subject II

2

Student Information

First Name

Last Name

Email Address

Date of Birth (BS)

Date of Birth (AD)

Gender

Male Female Other

3

Permanent Address

Province

District

Municipality / VDC

Ward No. / Village

4

Family & Guardian Details

Relation	Full Name	Occupation	Contact Number
Father
Mother
Local Guardian

5

Academic Background

Previous School / College Name	Board	GPA / Percentage	SEE Symbol No.

6

Declaration

I hereby solemnly declare that all the information furnished above is correct, complete and true to the best of my knowledge and belief. I understand that any false or misleading information may result in cancellation of my application. If selected, I agree to abide by all rules, regulations and code of conduct of the institution.

Signature of Applicant

Date:

Signature of Parent / Guardian

Date: